摘要
目的观察持续输注瑞芬太尼抑制鼻内镜手术后拔管期间应激反应的效果。方法将66例ASAI—II级择期行鼻内镜鼻中隔矫正手术患者分为3组：瑞芬太尼0．075μg·（kg·min）。（R1组，n=22）、瑞芬太尼0．05μg·（kg·min）。（R2组，n=22）与空白对照组（C组，n=22）。手术结束时，R1组和R2组停用丙泊酚，R1组继续输注瑞芬太尼0．05μg·（kg·min）^-1，R2组继续输注瑞芬太尼0．075μg·（kg·min）。至拔出气管插管后5min，C组手术结束时同时停用丙泊酚和瑞芬太尼。观察3组停药前（TO）、拔管前（T1）、拔管后1min（T2）、3rain（T3）、5min（T4）时刻的血压和心率变化，同时观察3组患者苏醒时间的变化。结果2组患者的性别、年龄、体重、拔管前SBP、DBP、HR差异无统计学意义（P〉0．05）。2组患者的睁眼时间、拔管时间差异无统计学意义（P〉0．05）。空白组苏醒时间明显短于瑞芬太尼组，3组患者苏醒时间R1组（9．8±2．6）min，R2组（8．9±2．3）min，C组（6．7±1．8）min，空白组苏醒时间明显短于瑞芬太尼组（P〈0．05）。结论术后以0．05～0．75μg·（kg·min）。速度持续静脉输注瑞芬太尼可减轻患者围拔管期心血管反应，患者可清醒耐受气管插管通气，是一种安全、有效、可控的麻醉方法。
Objective To observe the effect of tracheal extubation response of remifentanil infusion in nasal endoscopic operation.Methods Sixty six patients were divided into three groups ： The infusion rate of remifentanil was respectively 0. 075 μg·（kg·min）^- 1 （group R1 ） ,0.05 μg·（kg·min）^-1（group R2） and control group （group C） until 5mins after tracheal extubation in the recovery pe- riod when operation finished. Hemodynamics, tolerance of tracheal tube and buking, the BP and HR, recovery time were evaluated when before operation （ T0）, before tracheal extubation （ T1 ）, 1 min after tracheal extubation （ T2）, 3 mins after tracheal extubation （ T3 ）, 5 rains after tracheal extubation （T4）. Results The incidence rate of buking and muscle inflexible was significant lower in group R1 and group R2 than that group C. The patients who could be tolerant tracheal tube in in group R1 and group R2. The recovery time of C group was shorter than remifentanil groups. Conclusion Continous remifentanil infusion at 0.05 - 0.75μg·（kg·min）^ -1 can effectively prevent hemodynamics reaction to tracheal extubation in patients undergoing TIVA anesthesia in nasal endoscopic operation.
出处
《宁夏医学杂志》
CAS
2013年第11期1035-1037,共3页
Ningxia Medical Journal
基金
宁夏医科大学校级课题(XQ2012006)
关键词
瑞芬太尼
气管拔管
鼻中隔手术
内镜手术
应激反应
Remifentanil
Tracheal extubation
Nasal septum surgery
Endoscopic surgery
Stress reaction
